The new government of French President Francois Hollande has announced that it will move soon to legalise same-sex marriage and same-sex adoption. With pressure building up in countries like the US, Australia and the UK, perhaps it is time to ask where the children for male couples will come from. This is not a question which has been very prominent in the world-wide debate, so BioEdge has done some research of its own. We sent emails to a number of IVF clinics in the US and India asking whether they were preparing for a rising demand for surrogate mothers because of the legalisation of same-sex marriage.

The answer was a resounding Yes. Of course, our survey is far from being scientific, let alone comprehensive, but it does suggest that many needy women in developing or economically troubled countries are going to be working for gay couples looking for deals on cheap gestational carriers.

“The main reason patients travel from abroad to India is for excellent personal care, expertise and lot of savings on the treatment costs,” says Dr Samundi Sankar, of Srushti Fertility Research Centre in Chennai, India. “The costs that they pay here is almost 1/5th the costs they pay for surrogacy in US and Europe.” He gets a lot of inquiries from gay couples in the US and Israel. Is he preparing for an increase in demand? “Definitely, Yes.”

Dr Samit Sekhar, of the Kiran Infertility Centre, in Hyderabad, also forecast an increase.

“Yes, we have a sizeable number of gay population that visit our clinic to have a baby using the services of an egg donor and we have seen an increase in the number of gay couples and single men approaching our clinic as soon as legitimacy to their public union is granted in their respective states or country.

“Our clinic is open to all people, whether single, straight or gay, does not matter to us. We do not advertise ourselves as being gay or heterosexual friendly. We are a clinic that specializes in fertility related treatment.”

Because most clinics accept requests from all clients – married and unmarried couples, singles, gays or heterosexual – they do not necessarily differentiate between single heterosexual and homosexual males. “Some of them project themselves as singles but we are not sure whether they are singles or gay,” says Dr Himanshu Bavishi, of the Bavishi Fertility Institute, in Ahmedabad. “[If] the law in their country does not permit gay relationship, they project themselves as single.”

There was one dissenting voice. A public relations agent for Dr Shivani Sachdev Gour, of Surrogacy Centre India, Megan Sainsbury, rebuked BioEdge for its inquiry. “We are not preparing for an expansion of services for gay couples. Why would you ask this? If same sex marriage were legalised in any country, we will support this, but do not believe this will bring on a rush of clients.” However, about half of the contented couples featured on Dr Shivani’s blog are gay.

What about allegations of exploitation of poor women, especially in India? A couple of months ago in Ahmedabad a surrogate mother for an American woman died in the eighth month of her pregnancy. Dr Samit Sekhar, of the Kiran Infertility Centre, tackled this problem head on.

“It is difficult for a Person from abroad (journalist) to offer a correct picture of so called “reproductive tourism” in India because they have never lived here for more than a few days. Have they ever tried to stay in the house of a woman who agrees to be a surrogate mother? I am sure they would walk out after a few hours. Unfortunately the level of poverty in India especially rural India is such that surrogacy opens up a whole new window of opportunities for these women and their families.”

Comments from one of the leading infertility doctors in the United States, Dr Jeffrey Steinberg, who runs The Fertility Institutes in Las Vegas and Los Angeles, suggest that American IVF clinics are also anticipating a surge in demand for surrogates for gay couples. He told BioEdge:

“We have followed the legislation over the years related to gay marriage both internationally and nationally. What has emerged is fairly predictable trends.

“When a country begins to consider legalizing gay marriage, we get a surge (primarily internet based but also by telephone) of inquiries regarding the ‘basics’ of becoming involved with an egg donor and surrogate. About 1/3 of the inquiries continue on to seek our services even before the legislation is passed; 1/3 advise us they are waiting to see what developed with legalization; and we don’t hear immediately back from 1/3.

“In instances where marriage is actually legalized, we get another surge of inquiries including hearing back from those that contacted us with a ‘wait and see’ response. Once legalized, about 40% of the ‘new’ inquiries want to sign up, and we ultimately hear back from about 30% of the remainder.”

At the moment Dr Steinberg uses only carefully screened American surrogates — but this could change.

“We operate a large office in Guadalajara, Mexico and have watched carefully the laws evolving. Mexico City has apparently legislated some tolerance of gestational surrogates and we are looking into this. The State of Jalisco, where our Guadalajara facility is has no laws one way or the other. We will be watching Latin America closely.”

The dynamics of the relationship between same-sex marriage and surrogacy appear to be poorly understood. There are no good statistics on the clients of the surrogacy agencies which are proliferating on the internet in countries like India, Guatemala, Cyprus, and the Ukraine. Little is known about whether surrogacy really helps women to escape from poverty or debt. Media reports have painted pictures of “baby farms” and “baby factories” in India. But there are no reliable figures available even about the number of IVF clinics there.

What is certain is that demand for cheap wombs will grow to bring gay men the happiness of being the parent of their own child. What is uncertain is the long-term benefits for the women who bring these children into the world.